Provider Demographics
NPI:1609226398
Name:SHERI CAMPBELL, LISW-CP/AP-S
Entity type:Organization
Organization Name:SHERI CAMPBELL, LISW-CP/AP-S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:K
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP/AP-S
Authorized Official - Phone:803-608-9387
Mailing Address - Street 1:610 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2514
Mailing Address - Country:US
Mailing Address - Phone:803-608-9387
Mailing Address - Fax:
Practice Address - Street 1:610 HOLLY ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2514
Practice Address - Country:US
Practice Address - Phone:803-608-9387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty